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Home My WebLink AboutGRD2021-00011 - GRD Permit / Conditions - 12/22/2021 sox Cavh? MASON COUNTY PERMIT NO. 2 2 DEPARTMENT OF COMMUNITY DEVELOPMENT IJlO i BUILDING.PLANNING•FIRE MARSHAL WWW.CO.MASON.WA.US (360)427-9670 Shelton ext.352 Mason County Bldg.8, (360)275-4467 Belfair ext.352 615 W.Alder Street,Shelton,)(VGA 4 (360)482-526"—C f— /E D LAND O�CATION PERMIT (Grading g Permit)AUG 0 5 2021 OWNER INFORMATION: CONTRACTOR INFORMATION:. J-VV.Mraer Street NAME. r 'ct. Fmnk NAME: MAILING ADDRESS: L1 MAILING ADDRESS: CITY:6-ra e, i �LSTATE: ZIP: _ �(, CITY: STATE: ZIP: PHONE: ,1F _ �CELL: - , g5 PHONE: CELL: EMAIL: I 0,0M EMAIL L&I REG# EXP. PARCEL INFORMATION: PARCEL NUMBER(12 DIGIT NUMBER) l Z 7 O g- y Z- OOD 5 O FIRE DISTRICT_ LEGAL DESCRIPTION(ABBREVIATED):-T 2 5 c>f C V% (a-tt fo PC L. y o r i�cA�:*01 - 3.6 SITE ADDRESS 1-460 (' Srfve i=-14 i 5 I ti Nd ad ST � CITY�� o�✓:e w ci°5 5y6 DIRECTIONS TO SITE ADDRESS IS PROPERTY WITHIN 200 FT: Ye S SALTWATER® LAKE ❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ DOES PROPERTY HAVE SLOPE(S)WITHIN 300 FT OF THE PROJECT-GREATER THAN 14% YES❑ NO❑ WILL TIMBER BE CUT AND SOLD IN PARCEL PREPARATION? YES ❑ NON TYPE OF JOB: EXCAVATION ❑ FILLING N GRADING R CUTTING ❑ OTHER ❑ TOTAL SIZE OF PARCEL 2-S ACRES/SQ FT SIZE OF AREA TO BE EFFECTED 3 Z 0 D ACRE /SQ FT ESTIMATED AMOUNTY OF CUBIC YARDS (-//y a K. DOES THE SITE HAVE SLOPES 14%OR GREATER YES❑ NOR DESCRIBE SCOPE OF WORK Pla c. r oo ra % (-11 N G w lo•,e- \/q-0/6 D-F' , C ( i✓� G c7� CA r P Q WILL FILL BE BROUGHT ON SITS? IF S ITS ADDRESS: `rb D WILL EXCAVATED MATERIAL BE TAKEN OFF SITE?IF YES,SITE ADDRESS: D DOES FILL CONTAIN POTENTIAL HAZARDOUS MATERIALS? YES❑ NO 14 HAS A SOILS REPORT BEEN COMPLETED ON SITE?IF YES,INCLUDE A COPY. YES❑ NO R1 WILL PROPSAL RESULT IN REDIRECTION OF ANY SURFACE WWATER RUNOFF? YES❑ NO 14 WILL WORK ALTER WHERE STORMWATER OF GROUND WATER ENTERS OR EXISTS THE SITE? YES ❑ NOW WILL QUALITY,QUANTITY OR VELOCITY OF STORM/GROUND WATER BE ALTERED? YES❑ NOR WU,L THE RUNOFF BE COLLETED/CONTROLLED BY INTERCEPTORS,CURTAIN DRAINS OR OTHER DEVICES? YES ❑ NO sR WELL THE LAND BE REPLANTED UPON COMPLETION? YES X NO❑ WILL THE PROPOSAL RESULT IN SLOPES STEEPER THAN THOSE CURRENTLY ON SITE? YES ❑ NO JR IS THE SITE WITHIN 200 FT OF A DESIGNATED SHORELINE OR A WETLAND? YES ❑ NO g OWNER/BUILDER acknowledges submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner,owners legal representative,or contractor. I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary parties,including any easement holder or parties of interest regarding this project.The owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection.This permitlapplication becomes null&void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF XSPE INACTIVITY QF THIS IT APPLICATION OF 180 DAY L INNfV14-�A,TE�E APPLICATION. fgnature of Applicant e 1 A k OWNER REPRESENTATIVE!CONTRACTOR Print Name (CIRCLE TO INDICATE) eox coUyr� MASON COUNTY PERMIT NO. Zq✓ ' DEPARTMENT OF COMMUNITY DEVELOPMENT �,�� BUILDING.PLANNING•FIRE MARSHAL 11 WWW.CO.MASON.WA.US (360)427-9670 S tq[Le 3 - -� Mason County Bldg.8, (360)275-4467 I V E D 615 W.Alder Street,Shelton,WA 98584 (360)482-5269 Elma ext.35 D MODIFICATION PERMIT (Grading Permit) AUG 05 2021 OWNER TION: CONTRACTOR INFO er Street NAME. ' r C'1- NAME: MAILING ADDRESS:tSTATE: _ MAILING ADDRESS: CITY:6:-y-0 e�., �/� ZIP: �(, CITY: STATE: ZIP: PHONE: ,1- ELL: - PHONE: CELL: EMAIL: t EMAIL : L&I REG# EXP. PARCEL INFORMATION: PARCEL NUMBER(12 DIGIT NUMBER) l Z) O g- y 2- 00050 FIRE DISTRICT_ LEGAL DESCRIPTION(ABBREVIATED):_-r R 5 o-�' C U% (-a-7 (o pe 1. 7 o-' >1cA�0 I - 3,( SITE ADDRESS `460 G''- Srtye�-b1 i 5 I ti.d i d S mot; CITY DIRECTIONS TO SITE ADDRESS IS PROPERTY WITHIN 200 FT: Yt S SALTWATER® LAKE ❑ RIVER/CREEK❑ POND ❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ DOES PROPERTY HAVE SLOPE(S)WITHIN 300 FT OF THE PROJECT-GREATER THAN 14% YES❑ NO❑ WILL TIMBER BE CUT AND SOLD IN PARCEL PREPARATION? YES ❑ NOX TYPE OF JOB: EXCAVATION ❑ FILLING X GRADING X CUTTING ❑ OTHER ❑ TOTAL SIZE OF PARCEL 2-5 ACRES/SQ FT SIZE OF AREA TO BE EFFECTED_?Z O D ACRE /SQ FT ESTIMATED AMOUNTY OF CUBIC YARDS I-/ly DOES THE SITE HAVE SLOPES 14%OR GREATER YES❑ NOR DESCRIBE SCOPE OF WORK Pla c s G va ra x 1-<<`/ G a f7• \/ot�o�S D,F' ( ( i✓� G `O"-) G1 PPC4 WILL FILL BE BROUGHT ON SITE? S TTE ADDRESS: N6 o L R Da WILL EXCAVATED MATERIAL BE TAKEN OFF SITE?IF YES,SITE ADDRESS: /V 0 DOES FILL CONTAIN POTENTIAL HAZARDOUS MATERIALS? YES❑ NO 60 HAS A SOILS REPORT BEEN COMPLETED ON SITE?IF YES,INCLUDE A COPY. YES❑ NO RJ WILL PROPSAL RESULT IN REDIRECTION OF ANY SURFACE WWATER RUNOFF? YES❑ NO 14 WILL WORK ALTER WHERE STORMWATER OF GROUND WATER ENTERS OR EXISTS THE SITE? YES ❑ NO 10 WILL QUALITY,QUANTITY OR VELOCITY OF STORM/GROUND WATER BE ALTERED? YES ❑ NOg WILL THE RUNOFF BE COLLETED/CONTROLLED BY INTERCEPTORS,CURTAIN DRAINS OR OTHER DEVICES? YES ❑ NO R WILL THE LAND BE REPLANTED UPON COMPLETION? YES a NO❑ WILL THE PROPOSAL RESULT IN SLOPES STEEPER THAN THOSE CURRENTLY ON SITE? YES ❑ NOR IS THE SITE WITHIN 200 FT OF A DESIGNATED SHORELINE OR A WETLAND? YES ❑ NO g OWNER/BUILDER acknowledges submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below.I declare that I am the owner,owners legal representative,or contractor. I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary parties,including any easement holder or parties of interest regarding this project.The owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection.This permit/application becomes null&void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF PE W INSACTIVITYQF THIS RMIT APPLICATION OF 180 DAYL INVPI ! E APPLICATION. X �T fgnature of Applicant e X 1 '_j a ��G OWNER I REPRESENTATIVE/CONTRACTOR Print Name (CIRCLE TO INDICATE) �ros5 Szc�-�zsv� f' a NG o /RECEgT 9 — XL4H 3YZ / YY►YY�(/*,�, � P PL N N 89 41 41 6 2 4. 73 Do !,P t —! im c ti - ` / �� \ - i nb CsAr2R / POOR)AT 'f' I 1 / 4N i G a / J ' / / \ �: &6 ALL SETBACKS ARE AS' R D l3 P T / A FF IPAT�O} p _ 30 / b�r5 s FROMTIiE FUR HEST PROD ION OF THL BUILDING AS BUILT CENTERLIM 12 GRAVEL ROAD NEW RESIDENCE swsLL BE / vE / i f Yvtirno ► g �G4810E•D L �� / I e ,/ ,, �vt�:1E FtcATiorr7 5�/1 / / / 1�1n o�t►ais oR To Y�oz / J I 1 ANY Ca4REJE INSTALLATION _ / / I / / ' I BROADCASTED Iw mom TFE cc 5 .3 'AT/ / / vE OF NEk-, RESI 19�08 a RSV 12.i v8 4a Lbl � y0 41�1 3 \ MA ccx� � / ust�a S S 10 89*37 5 / 9 I � RECEIVED STAIRS TO BEA6H \ \ 'co a � I \ PLANNiNG BUILT ON VERY \ � ^�I� 0 5 20\ \ \ 21 \ I / STE S PE \ \ \ Street I \ APP► I I I ' / \ \ P LAN N G: MASON C LAN ING 8E ON ITE ALA SETBACKS ARE , :ASURED 3 1 ET TO PRO IL\FROM THE FURTI'�EST I- J ' PRO CTION OF THE B 1LDIN0 ) By �'I LDS a °0 E RECIV °� ON 1`� AUG* 2 1019 Ider Street P""AN L NING N 9 41 41 6 2 / 1// &2/ / 1a 162, Gad ; 1 3 Deep 09-1 Cp SLOPE nb - .. . : . .. ... . 515 RAT DOOM �• / / / / / / 261-9 — \ 4'1DIDE GRAVE"N V e ' / I 11 \ FF(PATIO} 66� 3 ALL SETBACKS ARE--E�' R D P ]I//T p, M 1 30 6 � FROM�iE FURTHEST PROD ION OF THE BUILDING / L9E 1GQI� 1 I VSEW AS BUILT GRAVEL N 12 / co / / I 1 1 1 I BACK A OF m 1 �4 U / / l YYlYYY)l�V�J I FROM THIS ADCASTED L ° ,/ �� ROvIDE FI YERIFICATICN N 7 5 / / / / L, of THIS SEAuc r'RIOR ro 1 ANT CONC" INSTALLATION. / / / / ' I BROADCASTS IPE F�Gt1 THE 5p.l3 '�.,/` � AvE OF NEM'. RESIf— I � � 195\08 _ , r� 120108- q j 601yp 1 1 3 0 N °37'50" W 68�1.02 i \ \ RECEIVED STAIRS TO BEA�H \�MjG 0 5 2071 P 1 t : C: BUILT ON VERY . \` \ ALL SETBACKS ARE M ASURED / \ \ \ \ FR M THE FURT EST / STE S PE \ ��o FI�� T�� / I \ \ \ C _ d UILDINC�, MA80M COUNTY �4 CA%,% / CHA FROVAL �VD OD 60 to \ ohm 1 N� W 1 � - ag8� \ i � 1 \ bi is \ Z • �\ \ Sx \ m E \. C=cn 167.46 M .7 MERIDIAN- AS SHOWN ,\ 6/20/19 SITE PLAN RIEBE & ASSOCIATES,INC. PATRICA FUNK J270�RFE7GISTERED RESIDENCE FOR aaff CHo-rSC-r FkF--RL.ANNaNC3 oAie w PATRICA FUNK 1123 MAPLE AVENUE SW- SUITE 270 Ohs it SITE ADDRESS: RENTON, WASHINGTON 98057 PO BOX 693 STATE OF WSMNGTON 460 E STRETCH ISLAND RD S PH:(425)226-5344 FAX:(425)226-5344 GRAPEVIEW, WASHINGTON 98546 L be GRAPEVIEW. WASHINGTON 98546 EMAIL: EDRIEBEOMSN.COM ARCHnwr FILENAME AMp/MIGC